BOOSTER SHOTS: Oddities, musings and news from the health world

The rich really are different from the rest of us – at least when it comes to skin cancer.

That’s the conclusion of a new study from Archives of Dermatology that examined the incidence of melanoma among younger women of various income levels. Not only were melanoma rates highest among those with the highest incomes, the number of new diagnoses also grew fastest in that group too.

A team of California researchers zeroed in on non-Hispanic white women between 15 and 39, a demographic for which the incidence of melanoma has doubled over the last 30 years. (Plus, whites are responsible for more than 90% of all melanoma cases in the U.S.) Using data from the California Cancer Registry, they identified 3,800 women who had a total of 3,842 cases of malignant melanoma in two time periods: 1988 to 1992, and 1998 to 2002.

Among the findings:

Teens and women in the top 20% of socioeconomic status (SES) were six times more likely to be diagnosed with melanoma than their counterparts in the bottom 20%.

Among teens and women who lived in neighborhoods with the most UV radiation exposure, the rate of melanoma diagnosis was 73% higher for those in the top 20% of SES compared with those in the bottom 20%.

Among teens and women who lived in neighborhoods with a middling amount of UV exposure, the rate of melanoma diagnosis was nearly three times higher for those in the top 20% of SES compared with those in the bottom 20%.

For teens and women in the bottom 40% of SES, melanoma rates were essentially flat over the course of the study. For all other groups, the rate of diagnosis rose between the 1998-1992 period and the 1998-2002 period.

It’s certainly possible that more skin cancers are found in higher-income women because they have better access to doctors and thus are catching more of the dangerous growths. But the researchers don’t think that’s what’s going on. If it were just a matter of screening, doctors mostly would be finding more early-stage thin tumors. But in fact, doctors are finding more melanomas that are thick in addition to more that are thin.

The higher rates are probably due to the fact that women with money are more likely to take beach vacations, work in their gardens, visit tanning salons or just have time to go outside for a walk, the researchers wrote. Any of those activities would increase their UV exposure.

That suggests some interventions that could help reduce melanoma rates, they wrote. In Australia, where younger women of high SES have been targeted by prevention campaigns, things that have worked include:

Encouraging people to avoid outdoor activities in the middle of the day;

Construction of shade structures at bus stops, outdoor shopping centers and other “areas of high sun exposure;”

Promoting the use of sunscreen that’s waterpoof and has a high SPF; and

Making indoor tanning parlors off-limits to girls under the age of 18.